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Partner with first major pressure sore... not doing well.

It's been a while since I've posted. My partner has a Stage 4 ulcer on his right upper buttock that has been there for about 2 months. I travel extensively for my career. He was injured in 2005 and for the first 11 years I was home and never traveled. Now I am gone for 5 days at a time and home for 2 days. Don is T11 Asia A. He can provide his own care but this skin issue has really affected his strength and endurance. He sees his wound care people 2 times a week and at those visits they change the dressings. He is unable to change them himself. They have him on a wound vac.

They are asking him to consider having surgery for a flap and he is refusing. He refuses to stay out of his chair and refuses surgery if it means he will have to stay out of his chair.

He is 74 years old. He essentially lives by himself for 5 days out of 7. The wound care is way beyond my expertise.

Can someone live with a stage 4 wound without closing it? Or do they eventually require closing? He is very depressed about the situation and refuses any home nursing.

I'm a 68 yr. old T6/7 para 43 years post injury. I had a shearing wound started about 2 years ago from rubbing my bottom transferring over my wheels. First one ever. Went to a wound clinic and thought they had it closed but it was tunneling underneath and opened up again. After 6 more months of trying to get it to close they brought in a plastic surgeon. He thought it was a basic stitch together situation but would have to spend six weeks in a Clinitron bed in an assisted living facility.

A few days before the surgery, it got infected with sepsis and was tunneling towards my femoral artery. They had to go in and clean out the infected area wait two weeks, laying in a clinitron bed in the hospital. After the infection cleared up, they did the surgery. Two weeks in the hospital then transferred to an assisted living facility for another 6 weeks in a clinitron bed 24/7. After they put me on a low air mattress and finally a regular bed getting me up for longer periods of time. I was then allowed to go home.

I was terribly weak and had a hard time with transfers etc. Thank God for my wife as she was and is there for me when needed. I may have pushed it too much or there was still some infection left as the flap opened up again. We tried for another three of four months with the Plastic surgeon working on techniques to get it to close. I spent most of the day off my ass but to no avail.

He went in a second time to see what was going on and found a pocket under the skin he could almost out his whole hand in. This time he did what they call a full rotational flap. Again there was the weeks in hospital and 8 weeks in assisted living in a Clinitron bed. Rather than stay in the facility for rehab, I went home and am rehabbing here. I have better equipment and better care at home than in a facility.

About three weeks later I started getting delirious for some reason. It came and went. There happened to be a PT at my home and insisted my wife call 911 immediately. They rushed me to the ER and almost lost me as they could not get my blood pulse higher than 60/40. He had one more thing to try and was going to let me go if it didn't work; what they called a clean line. It's a line inserted into the jugular vein that goes to just above the heart for IV antibiotics. They thought I may have had pneunomia or a UTI. once I stabilized, they were going to send me home. I insisted on having a cat scan done on the abdomen before leaving. They found three abscesses surrounding my flap. So back on IV antibiotics and three weeks, in a clinitron, with drains to relieve the fluids from the abscesses. I came home three weeks ago with a picc line for two types of antibiotics for four to six weeks. The infection didn't reach the bone but we're treating it as though it has to be sure. I see the infection doc. this Friday for an update. I feel the infection was there all along and thats what made my fist flap fail.

This all went down since last May. So is really new to me and like your partner I am very, very active. I'm sure the nurse and other will post that he has to stay off it. Stage four is pretty extensive and prone to infection. I've known guys who have lost their leg and hip due to a sore getting out of hand. Another kid I know had his tunnel up into his bladder to the point he was peeing out of his wound and didn't know it.

My wife does all my wound care; it's not that difficult to do once you've learned what to do. He should definietly have home nursing if he is living alone. I know his frustration as I had the same attitude but eventually, they get worse and in my case infected.

Two months is not that long. There are so many different remedies out there that are being used. But if he doesn't stay off it, they won't work. If he does decide on a flap make sure its by a Plastic Surgeon and not a general surgeon. Is he a veteran? If so he may be eligible for VA assistance.

Thank you Patrick... I don't know what to say except.. you are really lucky to be alive... I have begged Don to join Carecure and he refuses. I have tried to stress the severity of the situation. He is a vet and has seen them in the past for care bu he doesn't like them. He is gong back to them to be re mapped for a new cushion but they may not do that until he is stable. I will print out your response and give it to him. Thanks again.
Sieg

Thank you all. It has been rather daunting but trustfully this too shall pass. I'm not one to share on the woes in life cause we all have them. I've gotten up in my stander a few times and getting stronger. Once the picc line comes out, it's back in the gym with my trainer and on the Handcycle again.

My main concern here is for the OP's partner. It's tough he has a P/S but he's in Denver where one of the best rehabs in the world is and is also a vet with VA available. We all know if we don't take care of a challenge; eventually the challenge will make sure it gets the attention it needs; good or bad.